Greetings from iainthepict. This blog of mine is meant to be like a 'Book of Days' or a kind of 'Scottish Year Book' if you will. The idea was to present an event for each day of the year. Somewhere in here, you can find out what happened, affecting Scotland and the Scots, on any given day of the year. Your comments and observations are very welcome.
The photograph is by Sam Perkins (check him out on Facebook at Sam Perkins Photography) and was taken near Oban.

Thursday, 28 October 2010

Robert Liston, surgeon

Robert Liston, surgeon, teacher, inventor and author, was born on the 28th of October, 1794.

Robert Liston, described as the ‘The Great Northern Anatomist’ or the ‘fastest knife in the West’, was a pioneering surgeon who was widely considered to be the best of his era. His reputation spread throughout Europe and America, but at home in Britain, he was a bit of a controversial figure. He was both skilful and daring, and not short of self-confidence. He was also a showman and revelled in being able to carry out operations that others rejected. Liston struck a fine balance between rashness and speed. And in an age when hospital hygiene was unheard of, a high proportion of his patients lived to be grateful for the swiftness of his knife. It was Richard Gordon, a modern biographer of Liston, who christened him as ‘the fastest knife in the West’, meaning the West End of London where Liston worked as Professor of Clinical Surgery at University College. It is said that he could amputate a leg in a mere two and a half minutes, but that probably still felt like an age to the patient in question who was most likely suffering from shock as well as the pain.

In addition to being a dab hand with a knife, Liston was also a teacher of surgical methods and an inventor. The list of his life saving inventions contains several medical instruments that even today remain in use. He invented the ‘Liston splint’, still in use to stabilise dislocations and fractures of the femur, the ‘bulldog’ locking forceps, which are still used to seal arteries against blood loss, and see-through, isinglass (Ichthyocolla) sticking plaster. As a teacher, Liston taught by example and taught simplicity in all operative procedures and in that capacity, he was also the author of ‘The Elements of Surgery’ and ‘Practical Surgery’, both of which were published in the 1830s.

One of the things he is most famous for is being the first surgeon in Europe to perform an operation using ether as an anaesthetic. The ether, at that time a revolutionary new substance from America, was used on the patient and the operation took place on the 21st of December, 1846, at the University College Hospital in London. That was before another famous Scot, Sir James Young Simpson, who knew Liston and had observed his work, introduced chloroform. Liston’s ground breaking operation, typically for him being an amputation, was performed on one Frederick Churchill and took just twenty-eight seconds. You’d think he would have taken his time on that occasion, but maybe he was nonetheless wary of the efficacy of the ether. His success was reported thus, in the London ‘People’s Journal’: “Oh, what delight for every feeling heart… the announcement of this noble discovery of the power to still the sense of pain, and veil the eye and memory from all the horrors of an operation. ...we have conquered pain!” That reads like the editor of the paper was looking to take some of the credit.

There are many stories about Liston and his operations; some of them no doubt true and some archetypal. Some horrible mistakes are attributed to him, including an occasion when he reputedly amputated an assistant's fingers and a patient's leg with a single flash of his blade. Worse still, both later died; the assistant of septicaemia and the patient from gangrene. In another version or a similar story, his enthusiasm got the better of him and he sliced off the patient's testicles as well as the leg. You couldn’t make it up. You could imagine him being played by Johnny Depp as the swashbuckling surgeon in a bottle-green coat, wearing gumboots and with a bloody knife clasped between his teeth.

Liston was also a contemporary of Robert Knox, of Burke and Hare fame, but by contrast, Liston’s character and ethics were never in question. Indeed, on one particular occasion, when he had discovered the body of a young woman on display in Knox’s dissecting rooms, Liston was so offended that he used the old fisticuffs on the anatomist. The woman, who was called Mary Paterson, had been known to students and that they should dissect her body offended his sense of decency. It was later discovered that she had been murdered by Burke and Hare, and Knox was thought complicit in their activities.

Robert Liston was born in Ecclesmachan, near Linlithgow, on the 28th of October, 1794. His father, Henry, was a Minister and the inventor of the Euharmonic Organ and an improved plough with an inclined wheel, which he patented. Robert was educated at the Medical School at Edinburgh University, where he studied anatomy under Dr John Barclay. He completed his education in London and after a total of eight years of study, he returned to Edinburgh in 1818, to be appointed Lecturer in Anatomy and Surgery at the University. He also practised surgery at the Edinburgh Royal Infirmary, from 1827. He was popular with his students and the public, but didn’t get on with his peers. He ‘got their backs up’ with his showmanship and his ‘showing up’ of their inadequacies by performing operations in the tenements of the Grassmarket and Lawnmarket, on cases they’d give up as hopelessly incurable, didnae help. In a sense, they banished him south, but instead of going to Coventry, he accepted the Chair of Clinical Surgery at University College, London. He left Edinburgh in 1835, after a civic dinner in his honour, and spent the rest of his days London chopping off bits of people. Robert Liston died in London on the 7th of December, 1847.

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